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Nursing Pharmacology · Nursing Pharmacology Quiz

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A patient taking clopidogrel is scheduled for an elective procedure and reports taking an over-the-counter herbal supplement.

Which nursing action is most important?

A. Obtain the exact supplement and communicate all antiplatelet and supplement use to the procedural team
B. Tell the patient to stop every medication independently
C. Recommend adding aspirin
D. Delay documenting the supplement until after surgery
E. Assume supplements do not affect bleeding

Expert Explanatory Rationale

Correct Answer: A. Obtain the exact supplement and communicate all antiplatelet and supplement use to the procedural team

Clopidogrel increases bleeding risk, and some supplements may add to that risk. The procedural team needs a complete medication history.

Question 2 of 15

Case excerpt

A patient with Parkinson disease says carbidopa-levodopa wears off before the next scheduled dose.

In the case involving a patient with parkinson disease says carbidopa-levodopa wears off before the next scheduled dose, what is the nurse's best response?

A. Tell the patient to stop protein permanently
B. Document the timing of symptoms and refer the pattern to the prescriber for regimen review
C. Recommend doubling the next dose
D. Explain that wearing-off cannot be treated
E. Suggest skipping doses when symptoms are controlled

Expert Explanatory Rationale

Correct Answer: B. Document the timing of symptoms and refer the pattern to the prescriber for regimen review

End-of-dose wearing-off may require adjustment of the medication schedule or regimen by the prescriber.

Question 3 of 15

Case excerpt

A patient receiving heparin by infusion has a platelet count that has fallen by more than 50% from baseline.

Which complication should the nurse suspect?

A. Vitamin B12 deficiency
B. Iron-deficiency anemia
C. Dehydration
D. Heparin-induced thrombocytopenia
E. Hyperthyroidism

Expert Explanatory Rationale

Correct Answer: D. Heparin-induced thrombocytopenia

A substantial platelet fall during heparin exposure raises concern for HIT, a prothrombotic immune reaction. Stop heparin and urgently notify the prescriber according to protocol.

Question 4 of 15

Case excerpt

A patient taking an SSRI reports agitation, sweating, diarrhea and muscle twitching after starting linezolid.

Which adverse reaction is the priority concern?

A. Serotonin syndrome
B. Hypoglycemia
C. Ototoxicity
D. Opioid withdrawal
E. Neuroleptic malignant syndrome from dehydration

Expert Explanatory Rationale

Correct Answer: A. Serotonin syndrome

Combining serotonergic agents with linezolid can precipitate serotonin syndrome. Agitation, autonomic symptoms and neuromuscular findings require urgent assessment.

Question 5 of 15

Case excerpt

A patient with a new prescription for alendronate asks how to take the weekly tablet.

Which instruction is correct?

A. Crush it into yogurt
B. Take it at bedtime with milk
C. Take it with plain water on arising and remain upright for at least 30 minutes
D. Lie down immediately after swallowing
E. Take it with calcium at the same time

Expert Explanatory Rationale

Correct Answer: C. Take it with plain water on arising and remain upright for at least 30 minutes

Alendronate should be taken with plain water while fasting; remaining upright reduces esophageal irritation.

Question 6 of 15

Case excerpt

A patient taking rifampin for tuberculosis notices orange discoloration of urine and tears.

When counseling the patient described in the case involving a patient taking rifampin for tuberculosis notices orange discoloration of urine and tears, which response is appropriate?

A. Tell the patient to stop the medication immediately
B. Advise avoiding all fluids
C. Explain that orange-red body fluid discoloration is an expected effect and discuss contact-lens staining
D. Recommend taking the drug only once weekly
E. Explain that this always indicates kidney failure

Expert Explanatory Rationale

Correct Answer: C. Explain that orange-red body fluid discoloration is an expected effect and discuss contact-lens staining

Rifampin commonly discolors body fluids orange-red and may stain soft contact lenses. Other concerning symptoms should still be reported.

Question 7 of 15

Case excerpt

A patient with type 2 diabetes taking a sulfonylurea is found diaphoretic and confused before lunch. Capillary glucose is 48 mg/dL; the patient is awake and can swallow.

In the case involving a patient with type 2 diabetes taking a sulfonylurea is found diaphoretic and confused before lunch, what is the nurse's best response?

A. Wait for the next meal tray
B. Administer the scheduled sulfonylurea
C. Restrict oral intake
D. Give long-acting insulin
E. Give a fast-acting oral carbohydrate and recheck glucose according to protocol

Expert Explanatory Rationale

Correct Answer: E. Give a fast-acting oral carbohydrate and recheck glucose according to protocol

An awake patient who can swallow should receive fast-acting carbohydrate for hypoglycemia, followed by repeat glucose assessment.

Question 8 of 15

Case excerpt

A patient taking an ACE inhibitor has a persistent dry cough but no respiratory distress.

When counseling the patient described in the case involving a patient taking an ace inhibitor has a persistent dry cough but no respiratory distress, which response is appropriate?

A. Recommend stopping the drug without contacting the prescriber
B. Explain that cough can occur with ACE inhibitors and report it for medication review
C. Add an over-the-counter decongestant without assessment
D. Explain that cough proves the medication is ineffective
E. Tell the patient to double the dose

Expert Explanatory Rationale

Correct Answer: B. Explain that cough can occur with ACE inhibitors and report it for medication review

A persistent dry cough is a recognized ACE inhibitor adverse effect; the prescriber may consider an alternative.

Question 9 of 15

Case excerpt

A patient is starting phenytoin after recurrent seizures.

Which teaching points are appropriate? Select all that apply.

A. Report rash, fever or mouth sores promptly
B. Do not stop the medication abruptly without medical advice
C. Keep follow-up drug-level and laboratory appointments as ordered
D. Discuss interactions before starting new medicines
E. Take extra doses after a breakthrough seizure without instruction
F. Maintain regular dental hygiene

Expert Explanatory Rationale

Correct Answer: A. Report rash, fever or mouth sores promptly; B. Do not stop the medication abruptly without medical advice; C. Keep follow-up drug-level and laboratory appointments as ordered; D. Discuss interactions before starting new medicines; F. Maintain regular dental hygiene

Phenytoin requires adherence, oral care, monitoring and attention to serious skin reactions and drug interactions.

Question 10 of 15

Case excerpt

A patient taking a selective serotonin reuptake inhibitor begins a new prescription for another serotonergic medicine.

Which symptoms should prompt urgent evaluation for serotonin syndrome? Select all that apply.

A. Mild dry skin alone
B. Diaphoresis and fever
C. Diarrhea
D. Clonus or hyperreflexia
E. Tremor with autonomic instability
F. Agitation or confusion

Expert Explanatory Rationale

Correct Answer: B. Diaphoresis and fever; C. Diarrhea; D. Clonus or hyperreflexia; E. Tremor with autonomic instability; F. Agitation or confusion

Serotonin syndrome may include mental-status changes, autonomic instability, gastrointestinal symptoms and neuromuscular hyperactivity.

Question 11 of 15

Case excerpt

A patient taking metformin has an acute illness with repeated vomiting and poor oral intake.

Which considerations are appropriate? Select all that apply.

A. Follow the sick-day medication plan provided by the clinical team
B. Seek advice about temporarily holding metformin if significant dehydration or acute kidney injury is possible
C. Check glucose more frequently as directed
D. Restart or continue according to clinical guidance once the acute issue resolves
E. Assess hydration and renal-risk symptoms
F. Take extra metformin to compensate for missed meals

Expert Explanatory Rationale

Correct Answer: A. Follow the sick-day medication plan provided by the clinical team; B. Seek advice about temporarily holding metformin if significant dehydration or acute kidney injury is possible; C. Check glucose more frequently as directed; D. Restart or continue according to clinical guidance once the acute issue resolves; E. Assess hydration and renal-risk symptoms

Acute dehydration can increase risk of metformin-associated complications; sick-day guidance and clinical review are important.

Question 12 of 15

Case excerpt

A patient is prescribed an oral bisphosphonate for osteoporosis.

Which administration instructions are correct? Select all that apply.

A. Separate calcium supplements according to product instructions
B. Remain upright for the required period after taking it
C. Take it immediately before lying down
D. Take the tablet with plain water
E. Report new difficulty or pain with swallowing
F. Take it on an empty stomach as directed

Expert Explanatory Rationale

Correct Answer: A. Separate calcium supplements according to product instructions; B. Remain upright for the required period after taking it; D. Take the tablet with plain water; E. Report new difficulty or pain with swallowing; F. Take it on an empty stomach as directed

Correct administration reduces esophageal irritation and supports absorption; swallowing symptoms require review.

Question 13 of 15

Case excerpt

A patient receiving chemotherapy has a low neutrophil count.

Which medication-safety instructions are appropriate? Select all that apply.

A. Receive live vaccines without checking with the oncology team
B. Perform careful hand hygiene
C. Follow food-safety advice from the oncology team
D. Report fever promptly
E. Avoid close contact with people who are acutely ill when counts are low
F. Keep scheduled blood count monitoring

Expert Explanatory Rationale

Correct Answer: B. Perform careful hand hygiene; C. Follow food-safety advice from the oncology team; D. Report fever promptly; E. Avoid close contact with people who are acutely ill when counts are low; F. Keep scheduled blood count monitoring

Neutropenia increases infection risk; fever is urgent and infection-prevention guidance and laboratory monitoring are important.

Question 14 of 15

Case excerpt

A patient is prescribed 1,200 mg of a medication in two equal doses each day.

How many milligrams should be given per dose?

Expert Explanatory Rationale

Correct Answer: 600

1,200 mg divided by 2 doses equals 600 mg per dose.

Question 15 of 15

Case excerpt

A nurse identifies that a patient's potassium level is critically low before a scheduled IV insulin infusion.

Place the safety actions in the correct order.

A. Initiate prescribed potassium replacement
B. Begin or resume insulin when potassium is safe under the protocol
C. Review the potassium result and assess cardiac status
D. Notify the prescriber and follow the DKA protocol

Expert Explanatory Rationale

Correct Answer: C. Review the potassium result and assess cardiac status; D. Notify the prescriber and follow the DKA protocol; A. Initiate prescribed potassium replacement; B. Begin or resume insulin when potassium is safe under the protocol

Insulin can lower serum potassium further; assess, escalate, replace potassium and follow protocol criteria before insulin.

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